Should physicians and other healthcare professionals be required to perform procedures that violate their conscience? Most states have adopted so-called "conscience clauses" that shield doctors and others from being required to perform abortions, euthanasia, and other procedures when these would violate the doctor's own moral commitments.
Now, this allowance for conscience is under attack. Just last week, the California Supreme Court handed down a decision that denied a right for physicians who perform IVF procedures to claim a religious liberty right to deny those procedures to persons on the basis of sexual orientation. The unanimous decision resets the whole equation in the nation's largest state and sets the stage for similar reviews elsewhere.
Then, just days later, the Bush administration announced a new set of regulations that would deny federal funds to any hospital or medical service that does not allow healthcare professionals to "opt out" of procedures that violate conscience. Given the controversy surrounding these proposed regulations, we can expect this issue to be thrust into the current presidential race -- and probably soon.
A revealing look into the thinking of those who want conscience clauses eliminated or severely curtailed is found in a recent op-ed column contributed to The Los Angeles Times. In "When Religion and Healthcare Collide," Professor Richard P. Sloan of the Columbia University Medical Center argues against what he describes as a "disturbing trend" toward allowing doctors to exercise a right of conscience to opt out of certain procedures.
In his words, this disturbing trend is "an increasing willingness to allow the actions of individuals to disadvantage, and even endanger, others if those actions derive from religious faith."
Of course, there could be situations in which Dr. Sloan's logic would rightly apply. For example, we would not want to allow an emergency room physician to deny emergency treatment to a threatened patient -- any patient. We would not allow for a surgeon to refuse to perform a life-saving operation just because of the patient's sexual orientation.
If these were the situations that troubled Dr. Sloan, all persons of conscience would join in his call for action. But, as you might suspect, these are not the situations that concern him.
To the contrary, Dr. Sloan is concerned with doctors who want to opt out of "legal medical procedures" that they cannot perform without violating religious conscience. Lest we miss his point, he explicitly directs his concern toward the proposed Bush administration regulations that would allow medical professionals to opt out of procedures "including those associated with reproduction and terminal sedation." In other words, including abortion and euthanasia.
Dr. Sloan laments the fact that "studies have shown that 14% of U.S. doctors, when confronted by possibly objectionable but legal medical treatments, not only would refuse to deliver such care but also would refuse to inform their patients about it or refer them to physicians who would deliver the care." He estimates this means there are "about 40 million people who would receive substandard care from these physicians, who believe that their religious convictions are more important than the well-being of their patients."
The use of terms like "substandard care" and "possibly objectionable but legal" point to the essence of Dr. Sloan's radical argument. "Substandard care" is here applied to mean the refusal to use any legal procedure another physician may perform under a similar situation. Abortion, euthanasia ("terminal sedation") and other procedures are presented as "possibly objectionable but legal."
